MaineHealth - Memorial Hospital
3073 White Mountain Highway, North Conway, NH · MaineHealth · · NPI 1760436216
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Furnsh initial orthosis only HCPCS L1200 | not published | not published | $1,655.12 – $4,166.49 | 7 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $90.60 | $90.60 | $1.62 – $4.47 | 9 |
| Furosemide in ns IV syringe 2 mg/ml (neo/ped) - cnr HCPCS J1940 | not published | not published | $0.44 – $0.75 | 6 |
| Fuse bile ducts and bowel 47785 CPT 47785 | not published | not published | $2,988.76 – $6,554.32 | 8 |
| Fuse esophagus & intestine CPT 43340 | not published | not published | $1,286.67 – $2,807.45 | 8 |
| Fuse esophagus & intestine CPT 43341 | not published | not published | $1,288.00 – $2,818.28 | 8 |
| Fuse esophagus & stomach CPT 43320 | not published | not published | $1,302.64 – $2,842.01 | 8 |
| Fuse gallbladder & bowel CPT 47740 | not published | not published | $1,226.20 – $2,673.25 | 8 |
| Fuse gallbladder & bowel CPT 47741 | not published | not published | $1,375.59 – $3,001.30 | 8 |
| Fuse/graft added joint CPT 26863 | not published | not published | $212.47 – $458.19 | 8 |
| Fuse liver duct & intestine CPT 47802 | not published | not published | $1,452.26 – $3,106.48 | 7 |
| Fuse liver ducts & bowel CPT 47765 | not published | not published | $2,801.63 – $6,136.80 | 8 |
| Fuse pancreas and bowel CPT 48548 | not published | not published | $1,553.97 – $3,395.77 | 8 |
| Fuse pancreas cyst and bowel CPT 48540 | not published | not published | $1,216.96 – $2,656.98 | 8 |
| Fuse pancreas cyst and bowel 48520 CPT 48520 | not published | not published | $1,026.33 – $2,238.78 | 8 |
| Fuse upper gi structures CPT 47721 | not published | not published | $1,264.61 – $2,757.30 | 8 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $741.65 – $1,576.56 | 8 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $829.70 – $1,769.05 | 8 |
| Fusion of ankle joint open CPT 27870 | not published | not published | $965.84 – $2,062.55 | 8 |
| Fusion of big toe joint CPT 28750 | not published | not published | $556.52 – $1,505.94 | 9 |
| Fusion of big toe joint CPT 28755 | not published | not published | $323.07 – $973.98 | 9 |
| Fusion of facial/other nerve CPT 64866 | not published | not published | $1,183.26 – $2,526.17 | 8 |
| Fusion of finger jnt add-on CPT 26861 | not published | not published | $95.37 – $205.37 | 8 |
| Fusion of finger joint CPT 26860 | not published | not published | $592.68 – $1,257.99 | 8 |
| Fusion of finger tendons CPT 26471 | not published | not published | $639.45 – $1,358.99 | 8 |
| Fusion of finger tendons CPT 26474 | not published | not published | $630.70 – $1,337.98 | 8 |
| Fusion of foot bones CPT 28730 | not published | not published | $700.43 – $1,486.41 | 8 |
| Fusion of foot bones CPT 28735 | not published | not published | $751.34 – $1,588.09 | 8 |
| Fusion of foot bones CPT 28740 | not published | not published | $595.33 – $1,595.88 | 9 |
| Fusion of hand joint CPT 26843 | not published | not published | $754.48 – $1,606.38 | 8 |
| Fusion of knee CPT 27580 | not published | not published | $1,404.44 – $3,016.20 | 8 |
| Fusion of knuckle CPT 26850 | not published | not published | $711.34 – $1,510.81 | 8 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $720.17 – $1,530.46 | 8 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $835.42 – $1,781.94 | 8 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $845.26 – $1,802.95 | 8 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $806.86 – $1,717.54 | 8 |
| Fusion of skull arteries CPT 61711 | not published | not published | $2,408.54 – $5,368.18 | 8 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $763.26 – $1,620.61 | 8 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $1,004.98 – $2,137.09 | 8 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $666.88 – $1,428.13 | 8 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $622.89 – $1,331.88 | 8 |
| Fusion of thumb CPT 26841 | not published | not published | $747.13 – $1,588.76 | 8 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $664.96 – $1,422.02 | 8 |
| Fusion of toes CPT 28280 | not published | not published | $332.06 – $973.98 | 9 |
| Fusion of ureter & bowel CPT 50810 | not published | not published | $1,316.89 – $2,865.75 | 8 |
| Fusion of ureter & kidney CPT 50740 | not published | not published | $1,145.53 – $2,496.34 | 8 |
| Fusion of ureter & kidney CPT 50750 | not published | not published | $1,091.30 – $2,323.51 | 8 |
| Fxn gene charac alleles CPT 81285 | not published | not published | $109.93 – $559.61 | 7 |
| Fxn gene detc abnor alleles CPT 81284 | not published | not published | $54.80 – $278.96 | 7 |
| Fxn gene full gene sequence CPT 81286 | not published | not published | $109.93 – $559.61 | 7 |
| Fxn gene known famil variant CPT 81289 | not published | not published | $74.08 – $377.10 | 7 |
| G0180 home health certification HCPCS G0180 | not published | not published | $50.34 – $109.12 | 8 |
| G6pc gene CPT 81250 | not published | not published | $23.40 – $119.10 | 7 |
| G6pd full gene sequence CPT 81249 | not published | not published | $600.00 – $1,221.72 | 7 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $174.81 – $355.95 | 7 |
| G6pd known familial variant CPT 81248 | not published | not published | $375.25 – $764.08 | 7 |
| Ga-67 gallium 0.1 mci HCPCS A9556 | not published | not published | $34.12 – $137.72 | 9 |
| Ga-68 gallium 68 dotatate HCPCS A9587 | $374.73 | $374.73 | $51.09 – $352.25 | 9 |
| Gabapentin non-blood CPT 80355 | not published | not published | $3.74 – $50.16 | 4 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | $162.68 | $162.68 | $0.31 – $152.92 | 7 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | $116.95 | $116.95 | $1.50 – $109.93 | 9 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | $464.86 | $464.86 | $0.12 – $23.12 | 9 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | $285.35 | $285.35 | $14.73 – $261.56 | 9 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $10.40 – $42.90 | 7 |
| Galactokinase - sendout CPT 82759 | not published | not published | $10.61 – $43.74 | 7 |
| Galactose transferase test CPT 82776 | not published | not published | $4.70 – $23.90 | 7 |
| Galectin-3 CPT 82777 | not published | not published | $17.70 – $90.10 | 7 |
| Gallbladder and Bile Duct Scan (HIDA Scan) CPT 78226 | $1,894.00 | $1,894.00 | $32.97 – $955.25 | 9 |
| Gallbladder Function Scan (HIDA with Medication) CPT 78227 | $3,863.55 | $3,863.55 | $40.11 – $553.85 | 9 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | not published | not published | $622.42 – $1,350.18 | 8 |
| Gallium ga-68 dotatoc HCPCS C9067 | not published | not published | $4.05 – $7,407.53 | 7 |
| Gallium ga-68 psma-11, ucla HCPCS A9594 | not published | not published | $372.17 – $1,607.17 | 8 |
| Gallium ga-68 psma-11 ucsf HCPCS A9593 | not published | not published | $534.91 – $1,641.46 | 8 |
| Gallium illuccix 1 millicure HCPCS A9596 | not published | not published | $511.55 – $2,003.62 | 8 |
| Gallium locametz 1 millicuri HCPCS A9800 | not published | not published | $840.48 – $1,677.83 | 8 |
| Gallium nitrate injection HCPCS J1457 | not published | not published | $2.08 – $3.93 | 4 |
| Galsulfase injection HCPCS J1458 | not published | not published | $441.56 – $936.78 | 7 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $167.06 – $942.43 | 8 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $48.42 – $94.24 | 8 |
| Gammaglobulin iga CPT 82784 | $115.75 | $115.75 | $4.59 – $70.59 | 9 |
| Gammaglobulin ige CPT 82785 | $204.65 | $204.65 | $8.13 – $94.99 | 9 |
| Gamma glutamyltransferase CPT 82977 | $138.05 | $138.05 | $5.33 – $67.16 | 9 |
| Gammagraft HCPCS Q4111 | not published | not published | $7.14 – $13.87 | 6 |
| Gammaplex injection HCPCS J1557 | not published | not published | $54.57 – $105.68 | 8 |
| Gamunex-c/gammaked HCPCS J1561 | $10,478.45 | $10,478.45 | $48.03 – $2,888.90 | 9 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | $696.28 | $696.28 | $32.01 – $421.03 | 7 |
| Ganciclovir long act implant HCPCS J7310 | not published | not published | $8,601.28 – $31,470.53 | 4 |
| Gardner vag dna amp probe CPT 87511 | $489.30 | $489.30 | $17.33 – $76.66 | 9 |
| Gardner vag dna quant CPT 87512 | not published | not published | $20.62 – $85.03 | 7 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $2.69 – $13.66 | 7 |
| Gastric emptying imag study CPT 78265 | $1,637.80 | $1,637.80 | $43.35 – $1,375.75 | 9 |
| Gastric emptying imag study CPT 78266 | $2,169.05 | $2,169.05 | $46.26 – $1,822.00 | 9 |
| Gastric motility studies CPT 91020 | not published | not published | $68.38 – $143.68 | 8 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $26.13 – $54.90 | 8 |
| Gastrin test CPT 82938 | not published | not published | $8.74 – $36.02 | 7 |
| Gastroduodenostomy CPT 43810 | not published | not published | $950.41 – $2,071.37 | 8 |
| Gastroesophageal reflux study CPT 78262 | $1,162.50 | $1,162.50 | $30.82 – $976.50 | 9 |
| Gastroesophageal reflux test CPT 91034 | $852.30 | $852.30 | $46.51 – $715.93 | 9 |
| Gastrointestinal repair CPT 43360 | not published | not published | $2,056.08 – $4,512.12 | 8 |
| Gastrointestinal repair CPT 43361 | not published | not published | $2,506.28 – $5,473.24 | 8 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.